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Shrestha AK, Haas C. Pulmonary Embolism in Long Standing Diabetes: A Hint Towards Pancreatic Carcinoma. J Community Hosp Intern Med Perspect 2025; 15:118-122. [PMID: 39867139 PMCID: PMC11759090 DOI: 10.55729/2000-9666.1429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 09/30/2024] [Accepted: 10/15/2024] [Indexed: 01/28/2025] Open
Abstract
Pancreatic carcinoma has remained one of the leading causes of cancer-related mortality worldwide. Cancer originating in the head of pancreas is often detected early in the disease due to biliary obstruction resulting in jaundice. In contrast, cancer of the pancreatic body and tail remains indolent, presenting late with significantly increased tumor burden and distant metastasis. Unfortunately, a single laboratory screening study is neither sensitive nor specific for early detection of pancreatic cancer. In this report, we present a patient with longstanding diabetes incidentally detected to have pancreatic tail carcinoma while presenting with pulmonary embolism, emphasizing the need for pancreatic cancer screening studies in population with longstanding diabetes.
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Affiliation(s)
- Anish K Shrestha
- Medstar Health Internal Medicine Residency Program, Baltimore, MD, USA
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Yin Q, Zheng X, Han L, Huang X, Wang Y, Song Y, Zhang Y, Bian Y. Outcome of antithrombotic therapy in cancer patients with catheter-related thrombosis: a systematic review. Front Cardiovasc Med 2023; 10:1290822. [PMID: 38162134 PMCID: PMC10756912 DOI: 10.3389/fcvm.2023.1290822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction The guidelines' recommendations for anticoagulation in cancer patients with catheter-related thrombosis are unclear. The aim of this systematic review was to assess anticoagulation management in cancer patients with catheter-related thrombosis (CRT) based on previously published studies. Methods As of June 10, 2023,we searched databases including PubMed, Embase, and Cochrane and included 11 observational studies that met the criteria. We evaluated 770 adults with active cancer and objectively confirmed patients with CRT who were using drugs including warfarin, LMWH, and new oral anticoagulants as antithrombotic therapy. Results We extracted outcome data, including thrombosis recurrence, catheter dysfunction, major bleeding, and death, and performed a meta-analysis. Discussion In this study we found that the risk of VTE recurrence was higher with rivaroxaban, the risk of bleeding and death appeared to be greater with warfarin, and although the risk of catheter dysfunction due to LMWH is a concern, it is still a more reasonable option for cancer patients with catheter-related thrombosis. Systematic Review Registration http://www.clinicaltrials.gov, identifier (CRD42022367979).
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Affiliation(s)
- Qinan Yin
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, China
- Personalized Drug Therapy Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xingyue Zheng
- Personalized Drug Therapy Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Lizhu Han
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, China
- Personalized Drug Therapy Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xuefei Huang
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, China
- Personalized Drug Therapy Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yueyuan Wang
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, China
- Personalized Drug Therapy Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yujie Song
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, China
- Personalized Drug Therapy Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuan Zhang
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, China
- Personalized Drug Therapy Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuan Bian
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, China
- Personalized Drug Therapy Key Laboratory of Sichuan Province, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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